| NPI | 1881824365 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 63005) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125055678) | 
| 207R00000X Internal Medicine (Licence: OH 35.098843) | |
| Enumeration Date | 2009-07-20 | 
| Last Update Date | 2015-07-08 |